BLOOMFIELD, Conn. & ATLANTA--(BUSINESS WIRE)-- CIGNA (NYSE:CI) and Piedmont Physicians Group, part of Atlanta-based Piedmont Healthcare, have launched an accountable care organization (ACO) pilot program. With a comprehensive, accountable and collaborative approach to medical care, the ACO pilot is expected to improve access to and quality of patient care, and provide better care coordination while lowering medical costs.
An ACO is a variation on the patient-centered medical home model of health care that rewards primary care doctors for improved outcomes and lower medical costs. CIGNA's program with Piedmont is one of the first patient-centered pilot programs in the Atlanta area involving a medical practice and a single private payer and is the first accountable care organization in Georgia.
The program, which began July 1, is focused on approximately 10,000 individuals covered by a CIGNA health plan who receive care from one of Piedmont’s more than 100 primary care physicians who are members of the Piedmont Physicians Group.
“Piedmont physicians have been at the forefront of patient-centered care for over 100 years in Georgia,” said James Sams, M.D., medical director of Piedmont Physicians Group. “The launch of this program is a natural progression for leading the charge for better patient outcomes.”
During the ACO pilot, a Piedmont Physicians Group practice will monitor and coordinate all aspects of an individual’s medical care. Patients will continue to go to their current Piedmont physician and will not need to do anything to receive the benefits of the ACO pilot. There also is no change in any plan requirements regarding referrals to specialists. Patients who will see the immediate benefits are those who need help managing chronic conditions, such as diabetes.
Key to the CIGNA/Piedmont program is a registered nurse, funded by CIGNA and employed by Piedmont, who serves as a clinical care coordinator to help patients with chronic conditions or other health challenges navigate their health care system. The care coordinator will enhance patient care by coordinating CIGNA data and clinical programs of the Piedmont Physicians Group, as well as communications, appointment availability and education around those clinical programs. Using CIGNA data to help drive improved outcomes is one of the core strengths of the program.
“We believe that we can achieve better clinical outcomes by adopting a patient-centered model of primary care,” said Dr. David Epstein, CIGNA's senior medical director for Georgia. “Health care in the United States has shifted away from prevention and primary care, which has resulted in a ‘disease care’ system that relies more on specialist intervention and rescue procedures rather than improving health and providing greater value to patients. The patient-centered model places the focus back where it belongs – on improving the health of individuals through comprehensive primary care services and delivering better outcomes through enhanced care coordination.”
CIGNA will pay the primary care physicians of the Piedmont Physicians Group as usual for the medical services they provide, plus an additional fee for care coordination and other medical home services. The physicians also will be rewarded through a “pay for performance” structure if they meet targets for improving quality and lowering medical costs. According to CIGNA's Epstein, emphasizing the value of the primary care physician will help increase the professional satisfaction and financial rewards for doctors who practice in primary care.
CIGNA will evaluate results after the program has been operational for at least 12 months. The pilot is one of many that CIGNA participates in nationally and is intended to help the company gather data about the effectiveness of the patient-centered model. CIGNA's programs include multi-payer pilots in Colorado, New Hampshire, Pennsylvania, and Vermont, as well as CIGNA-only accountable care organization pilots in Connecticut, New Hampshire and Texas. CIGNA has been a member of the Patient-Centered Primary Care Collaborative since October 2007.
CIGNA (NYSE: CI) is a global health service and financial company dedicated to helping people improve their health, well-being and sense of security. CIGNA Corporation's operating subsidiaries in the United States provide an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, as well as group life, accident and disability insurance. CIGNA offers products and services in over 27 countries and jurisdictions and has approximately 60 million customer relationships throughout the world. To learn more about CIGNA, visit www.cigna.com. To sign up for email alerts or an RSS feed of company news, log on to http://newsroom.cigna.com/rss. Also, follow us on Twitter at @cigna, visit CIGNA’s YouTube channel at http://www.youtube.com/cignatv and listen to CIGNA's podcast series with healthy tips and information at http://www.cigna.com/podcasts or by searching "CIGNA" in iTunes.
About the Piedmont Physicians Group
The Piedmont Physicians Group (PPG) has more than 100 primary care physicians in over 30 offices throughout metro Atlanta. A member of Piedmont Healthcare (PHC), the PPG is governed by the Piedmont Medical Care Corporation and has been identified as a Better Performer for the sixth consecutive year by the Medical Group Management Association for superior operational service compared with similar medical group practices nationwide. PHC, a not-for-profit organization, also includes Piedmont Hospital, a 481-bed acute tertiary care facility in the north Atlanta community of Buckhead; Piedmont Fayette Hospital, a 143-bed, acute-care community hospital in Fayetteville and one of the 100 Top Hospitals® in the nation; Piedmont Mountainside Hospital, a 42-bed community hospital in Jasper; and Piedmont Newnan Hospital, a 143-bed, acute-care community hospital in Newnan. Piedmont Healthcare also is the parent company of the Piedmont Heart Institute (PHI), comprised of more than 85 cardiovascular specialists in Piedmont Heart Institute Physicians with over 30 locations across north Georgia and North Carolina; the Piedmont Clinic, a 600-member physician network; and Piedmont Philanthropy, the philanthropic entity for private fundraising initiatives. For more information, visit piedmontphysicians.org.
KEYWORDS: United States North America Connecticut Georgia
INDUSTRY KEYWORDS: Practice Management Health General Health Managed Care